Healthcare Provider Details

I. General information

NPI: 1144407503
Provider Name (Legal Business Name): ABDELAZIM OSMAN HASHIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ABDELAZIM O HASHIM M.D.

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 GOETHALS DR STE F KADLEC INLAND CARDIOLOGY,
RICHLAND WA
99352-3301
US

IV. Provider business mailing address

550 GAGE BLVD STE 101
RICHLAND WA
99352-9532
US

V. Phone/Fax

Practice location:
  • Phone: 509-942-3272
  • Fax: 509-942-3273
Mailing address:
  • Phone: 509-942-3627
  • Fax: 509-627-2983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD60388993
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD60388993
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: